[MVP Risk score and new atrial fibrillation diagnosis: Prospective cohort PREFATE study]

To assess the association between electrocardiogram (ECG) patterns according to the MVP ECG risk score (morphology-voltage-P-wave duration) and a diagnosis of Atrial Fibrillation (AF).

Prospective observational cohort study (1/01/2023-31/12/2024). SITE: Primary care.

Randomized sample of 150 patients aged 65-85 years without prior diagnosis of AF, stroke, or current anticoagulant treatment; high risk of future AF; CHA2DS2-VASc ≥2; and ability to use the FibricheckR application (App).

At baseline, a standard ECG, MVP risk score assessment, and cardiac rhythm monitoring for 15 days using the Fibricheck^R App were performed. The dependent variables were the presence of P-wave patterns on the electrocardiogram according to MVP risk score and a new diagnosis of AF.

The diagnosis of AF was confirmed in 14 cases (9.3%, 95% CI 5.6-15.1), 3 men and 11 women. In 3 cases, the arrhythmia was diagnosed on the baseline ECG, and in 11 cases by Holter after being reported as possible AF by the Fibricheck^R App. A higher prevalence of atypical advanced interatrial block (A-AIB) (p 0.007) was detected among participants with AF, as well as the prevalence of P-wave <0.1mV. (p=0.006). All new diagnoses of AF were made at scores ≥4 in the MVP risk score.

Using scales for identifying ECG patterns in high-risk subjects in primary care can facilitate the diagnosis of unknown AF.